Hazel McHaffie

Questions & Challenges for Paternity

Literary questions for reading groups

For discussion
  • Q. This story is predicated on secrets. How justifiable were they?
  • Q. Judy is a midwife. How much does her work influence developments in her personal life? Do you like her as a person?
  • Q. Sid Robertson and Jim Burrows are very different characters facing similar situations. How far do their contrasting responses a) fit with their personalities and b) influence the story?
  • Q. Sian, Declan and Georgina were brought up together by the same parents. What features of their upbringing do you think influenced each of them most?
  • Q. Declan has a rose-tinted picture of Judy. In what ways is he deluded and how does this influence developments in their relationship? If you were a marriage guidance counsellor what advice would you give them?
  • Q. In Declan’s shoes would you have responded to Dr Farnham’s revelation in the same way? What are the consequences of Declan’s decision not to tell Judy what he knows?

Moral and ethical questions

Paternity revolves around the central theme of what should be permissible in relation to assisted reproduction involving donated gametes.

Respect for autonomy
  • Q. When Dan Allanwood donated his sperm for medical use, the prevailing policies and procedures failed to detect the presence of a faulty gene, to prevent inadvertent incest, or to minimise the risk of a serious genetic defect in future offspring. How might the risk of these developments have been minimised?
  • Q.Until recently artificial insemination in the UK has been predicated on donor anonymity. Real life cases have challenged this practice and the law has now changed. Should sperm donors be
    • identifiable?
    • traceable?
    • paid?
  • Q. Isobel and Sid Robertson, and Betty Burrows all decided not to tell their children about the artificial insemination. Why did they withhold this information and were they right to do so?
Disclosure of information
  • Q. Both Declan Robertson and Judy Burrows had the names of their social rather than biological fathers on their birth certificate. Is this practice ethically acceptable?
  • Q. Georgina Robertson knows she may carry a faulty recessive gene. Just how much should she divulge to any partner with whom she plans to have a child?
  • Q. Imagine you are a) Sian, b) Declan and c) Georgina Robertson. How much will you tell your own children about their genetic history?
Rights and responsibilities
  • Q. Judy tells her mother that in cases involving donated gametes, the children’s rights should be considered. What are those rights and in the event of conflict, whose needs and rights should take precedence, the donors’ or the children’s?
  • Q. Is there a greater moral responsibility attached to donating sperm rather than blood or a kidney?
Conflicts between beneficence and autonomy
  • Q. Bethany Robertson died because both her parents carried a faulty recessive gene. What are the advantages and disadvantages of gene therapy?
  • Q. The chaplain, Geoff Frazer, comments on slippery moral slopes in two ways: Slopes are only dangerously slippery if you’re not properly prepared or dressed for them … It’s up to these official committees – and all of us, I guess – to monitor progress and ensure we don’t venture onto slippery slopes unwarily. We must have sufficient resolution and integrity to pull back if we feel there’s a danger of it getting too skiddy. We need to have the courage and strength of purpose to know we’ll do the right thing when the next moral choice has to be made, not sit there feeling so weak that we say no to any progress. To what extent do you share these views?
  • Q. While Judy is grappling with the options available to them for creating a child who is free from the serious medical condition from which Bethany died, she hears a professor of medical ethics speaking of “perilous knowledge”. How far should people be protected from potentially serious information about their genetic predisposition?
  • Q. Dr Keith Galloway did not share his suspicions about Judy and Declan with the Robertsons, his concern being only with issues of medical benefit. Dr Henrietta Farnham saw this as paternalistic behaviour. Who is right?
Justice
  • Q.With resources limited in a state-funded health service
    1. Should infertility treatment be freely available to anyone who wants it?
    2. Should there be limits set to who may receive it? If so, on what grounds?
    3. Do doctors have a moral responsibility for making such choices?
Ethical issues relating to artificial or assisted reproduction
  • Q. Declan, Georgina and Judy all react differently to news of their origins. Are their reactions equally defensible?
  • Q. Georgina perceives an ethical difference for medical staff between helping to create a new life and performing other medical procedures. How valid is such a distinction?
  • Q. Geoff Frazer has views on embryo destruction, infertility treatment, and allocation of resources (Chapter 33). To what extent do you share his conclusions?
  • Q. Sid and Isobel chose to undergo infertility treatment far from home. What are the advantages and disadvantages of such a course of action?
  • Q. If Sid and Isobel had elected to adopt a child instead of having infertility treatment, the medical, social and psychological vetting processes would have been much more rigorous than they were for assisted reproduction. Is this difference ethically defensible?
  • Q.In the case of both the Robertsons and the Burrows, the donor was selected to resemble the social fathers on basic characteristics such as height, colouring, ethnic origin.
    1. To what extent and based on which characteristics should couples be given a choice of sperm donor?
    2. Is there a slippery slope to the creation of designer babies?